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Biomedical subjects

M Z Cohen

Publications and source records attributed to M Z Cohen.

12 recordsLinked to original sources

Cancer clinical trials. Companion studies.

Nursing companion studies may accompany research in a variety of disciplines but most often are associated with medical research. Companion studies include "collaborative-companion" studies and "parallel-companion" studies and rely on a variety of methods. The majority of nursing companion studies have focused on the areas of treatment effects or symptoms, cancer control, and rehabilitation, however, there are many other areas that provide opportunity for independent nursing research.

Clinical Protocols

Impact of adult critical care hospitalization: perceptions of patients, spouses, children, and nurses.

This phenomenologic study describes the effects of adult hospitalization in a critical care setting on the family as perceived by patients, spouses, children in the family, and nurses. Tape-recorded interviews were completed with 12 spouses, 9 patients (2 mothers and 7 fathers), 11 children, and 12 nurses. Responses were analyzed by using systematic thematic content analysis. Themes that emerged with regard to how this event affected the family unit and individuals in the family included (1) lack of communication among family members; (2) protecting children from anxiety-provoking information; (3) overriding threat, exemplified by feelings of vulnerability, uncertainty, intense emotions, and physical illness in children; (4) disruption of normal home routines; (5) changes in relationships; and (6) role conflict. Nurses' perceptions of the impact of this event on parents, spouses, and children demonstrated some incongruences with perceptions of patients and family members. Practice implications from this study include the following nursing actions: (1) eliciting more comprehensive information about relationships among family members and the impact on the family; (2) developing mechanisms to promote communication among family members; (3) making referrals to community resources such as school nurses, counselors, and chaplains; and (4) teaching nurses and parents ways to help children cope with this event.

Adaptation, Psychological

Classification of nursing interventions for care of the integument.

The Classification of Nursing Interventions research team at The University of Iowa, College of Nursing is building a taxonomy of nursing interventions that will include all of the direct care treatment activities that nurses perform on behalf of patients. This report describes the study in which 12 nursing interventions and their associated activities for care of the integument were extracted from a large database and validated through a two-round Delphi survey. Using an adaptation of Fehring's model for determining diagnostic content validity of nursing diagnoses, a definition, critical activities, and supporting activities were developed for each of the following interventions: Bathing, Bedrest Care, Hair Care, Nail Care, Oral Health Maintenance, Oral Health Promotion, Oral Health Restoration, Positioning, Pressure Management, Skin Care--Topical Treatments, Skin Surveillance, and Wound Care. Further research is needed to validate supporting activities and to continue classifying interventions and activities that nurses use in treating impaired skin integrity (potential and actual) and altered oral mucous membrane integrity (potential and actual).

Delphi Technique

Love and work: oncology nurses' view of the meaning of their work.

Phenomenological interviews with 23 nurses and more than 200 hours of participant observation on units of one cancer hospital were conducted to obtain a better understanding of how nurses caring for patients with cancer view their work. When asked to discuss a "critical incident" that captures the essence of oncology nursing for them, most nurses described acute physiologic emergencies. A few nurses described psychosocial needs and explained how they had helped or were unable to help patients and families deal with these needs. A major theme in these incidents was how they related to the nurses' own lives. These findings suggest the need to provide nurses with support and an opportunity to discuss their work. Oncology nurses appear to be motivated by a deep concern for patients and families that creates tremendous stress when conditions such as poor staffing, excessive use of registry nurses, and unexpected crises occur. The task orientation of these nurses also seems to be based on their fundamental concern for patient welfare.

Adaptation, Psychological

Pain as a metaphor for illness. Part I: Impact of cancer pain on family caregivers.

While previous research has focused on patients' or professional caregivers' perspective of pain, this study describes cancer pain from the family caregivers' perspective. Chronic pain, which is associated with malignant disease, produces an intense burden on the patient as well as on the entire family. This qualitative study included 85 family caregivers of patients with cancer pain. Data were collected using an interview guide, and verbatim responses were analyzed for themes. The results identified four themes surrounding family descriptions of pain (anatomic descriptions, hidden pain, family fear and suffering, and overwhelming/unendurable pain) and three themes surrounding family experience of pain (helplessness, coping by denying feelings, and a wish for death). This study documents the important role that family members play in cancer treatment. If the number of patients receiving care in the home from family members continues to grow, this role will become even more important. Part I of this two-part paper focuses on the impact that cancer pain has on family caregivers and concludes that pain does have a tremendous impact on the family because it is perceived as a metaphor of progressive illness and death.

Adaptation, Psychological

Pain as a metaphor for illness. Part II: Family caregivers' management of pain.

Changes in the healthcare system have made the patient's home the primary site of cancer care. Family members, already burdened with the psychological impact of having a loved one with cancer, take on caregiving roles to meet the multiple and complex needs of the patient. Part I of this two-part article focused on family caregivers' descriptions of the patients' pain and the impact of this pain on caregivers. A model of the Caregiver Experience of Pain is provided along with implications for future inquiry and clinical practice. Themes identified in caregiver roles in medication administration included deciding what to give, deciding when to give, night duty, reminding/encouraging, keeping records, fear of addiction, and doing everything. Caregiver roles in nondrug interventions included positioning/mobility, massage, use of ointments/lotions, cold, heat, being there through touch, avoiding touch, and talk and other distractions. Caregiver perceptions of what doctors or nurses could do better included themes of being there, explain, be honest/listen, addiction concern, and giving medication. Caregiver questions included areas of future, understanding why, death, concern about medications, and fear about what to do at home. The study results offer important suggestions for oncology nurses in supporting family caregivers in the management of the patient in pain.

Analgesics

Inductive methodology and a research team.

Large teams of researchers using inductive methodologies are relatively rare and present unique challenges to team members. A team from the University of Iowa reports on what it experienced during a project to develop a taxonomy of nursing interventions.

Humans